POSITIVE PRACTICE ENVIRONMENT CAMPAIGN FOR HEALTH PROFESSIONALS HEALTH PROFESSIONALS UNITED IN PURSUING POSITIVE PRACTICE ENVIRONMENT 2013-2015
1. Positive Practice Environment Campaign: Health Professionals united in pursuing Positive Practice Environment 2013-2015 2. Executive summaries of the Campaign Partners (DENOSA and SAMA) 2.1 Democratic Nursing Organization of South Africa (DENOSA) The Democratic Nursing Organization of South Africa (DENOSA) is the largest nurses trade union in South Africa with over 82 000 members. It has a dual focus on both trade union and professional development offering training to nurses. Although DENOSA has its roots in unionism and representing the workplace interests of members, the organization took notice of the global developments amongst nursing unions to also include professional development of their members as part of their core focus. The organization has presence in all nine provinces and represents nurses across the country. DENOSA has as its vision nurses united in pursuing service excellence and its internal mission is to support, represent and develop its members as the backbone of South African health care. The organization is found on ten core values namely: Excellence and professionalism, Accountability, Transparency, Collectivism, Leadership development (including empowerment), Organizational growth, Diversity, Integrity and loyalty, Democracy and Visibility. 2.2 South African Medical Association The South African Medical Association (SAMA) aims to be the representative Association for the South African medical profession. Its mission is to empower doctors to bring health to the Nation. SAMA embraces 6 core values which serve as a compass for its actions and guide the organisation in the conduct of its business as they remain constant and these are: Leadership, Innovation, Vibrancy, Ubuntu, Professionalism and Principles. SAMA s objectives are as follows: ~ To represent doctors with authority and credibility in all matters concerning their interests in the health care environment ~ To promote the integrity and image of the medical profession ~ To develop medical leadership and skills Page 1
~ To provide doctors with knowledge relevant to the demands of medical practice ~ To promote medical education, research and academic excellence ~ To encourage involvement in health promotion and education ~ To influence the health care environment to meet the needs and expectations of the community by promoting improvements to health reform, policy and legislation. 3. Preamble and the overarching purpose of the campaign Alarming incidents that take place on a daily basis in health institutions around the country, resulting in death of patients amongst other things; have soured the relationship between the healthcare professionals and the communities affected. These incidents are threatening to overshadow the great strides that the Department of Health has made and continues to make in bringing about new changes and improvements in the country s health system. It is against this background that SAMA and DENOSA, decided to embark on a campaign in a bid to assist the Department of Health in improving the conditions in health institutions countrywide. We, the two organizations, acknowledge the great and positive triumphs that both our democratic government and the Department of Health have made in improving the health conditions of the masses in our country such as: the National Health Insurance (NHI), the fight against the burden of disease, and expanded roll-out of ARVs and prevention of new HIV infections and the positive results thereof. We therefore come together as health professionals to offer ourselves to be included as seekers of solutions to these challenges, making use of our insight as professionals to be party to the endeavors of our Department of Health and the democratic government in resolving these challenges. We hereby adopt the campaign on Positive Practice Environment (PPE) as a vehicle to raise awareness, educate and demonstrate our willingness to work hand in hand with the government to further improve the conditions of service of the health workers. We further acknowledge the commitment by the government to prioritize infrastructure development. 4. The 8 core pillars of the Positive Practice Environment (PPE) Campaign Positive Practice Environment for healthcare professionals consists of 8 pillars from which this campaign is built. These are as follows: Page 2
4.1 Workplace Safety Safety in the workplace is one of the key constituents of Positive Practice Environment (PPE). Workplace safety is multi-dimensional in scope and incorporates aspects such as: Occupational Health, Safety and wellness policies, Personal security, Environmental safety and risk management, Infection Control, Safe use of medicine, Equipment safety, Safe clinical practice and Safe care environment. Workplace safety for healthcare professionals is key to quality healthcare service provision to patients. Safety in the workplace extends beyond just safety of healthcare professionals into the safety of patients themselves as the beneficiaries of healthcare services and the care environment. The nature of occupation for healthcare professionals is a risky one and therefore requires a working environment supportive of the type work they undertake on a day-to-day basis. This prompts for strict adherence to safety policies by all involved in the healthcare system. A safe working environment enables healthcare workers to perform their duties without fear of danger or possible harm to their well-being. 4.2 Payment There have recently been reports of health professionals who have gone for months without getting paid salaries. Non-payment of healthcare professionals may lead to unmotivated healthcare personnel which in turn may lead to thoughts of leaving the profession. It is therefore essential that qualified and efficient human resources are capacitated to ensure that professionals are paid correctly and on time. Payment in this regard not only refers to payment of healthcare professionals in the form of remuneration but also refers to timely payment for the necessities in health facilities such as: suppliers, security personnel, caterers, cleaners, maintenance etc. The functionality of these enables the smooth day-to-day running of operations in healthcare facilities. 4.3 Equipment Equipment in healthcare facilities is one of the most essential resources without which healthcare facilities cannot function optimally. Various medical procedures require useful and appropriate equipment that is up-to-date and is of good quality and standard. The challenge with equipment is that its lifespan is quite dynamic and therefore requires constant upgrading maintenance. There also needs to be a strict mechanism in place that would ensure that hospital equipment is maintained and serviced regularly to ensure its optimal and effective usage. Page 3
4.4 Supplies Lack of basic necessities that enable professionals to carry out their day-to-day operations is a challenge in many of the healthcare facilities in our country. This includes supply of all the essential necessities such as: medication, protective wear, essential equipment, water, etc without which the healthcare facilities cannot function effectively. 4.5 Resources Resources and supplies are closely related elements. However, resources are not limited to consumables as they also include aspects such as: human resources, financial resources, essential healthcare facilities all of which enable the smooth running of healthcare facilities. Many health facilities operate without sufficient essential resources and therefore there needs to be sufficient allocation in the healthcare budget in this regard. 4.6 Education The appointment of poorly qualified personnel in key managerial positions in our healthcare facilities has been a challenge that has cost the healthcare system in our country dearly. It is therefore important that adequately qualified personnel are placed in key managerial positions. In this regard we welcome the Department of Health s initiative to introduce an academy for CEOs where newly appointed CEOs are trained prior to assumption of duty. Given the highly dynamic environment in which we are influenced by the technological developments and innovations, it is essential that health professionals continuously take advantage of professional development opportunities. This could be facilitated through the official introduction of Continuous Professional Development (CPD) points which would encourage health professionals to undertake training and educational activities to upgrade their qualifications whilst practicing. 4.7 Support Lack of support for professional development activities for healthcare professionals wishing to acquire training and educational opportunities discourages healthcare professionals. This includes both financial and moral support for health professionals. Support also refers to the degree of support amongst various healthcare professionals themselves as well as support between managerial personnel and personnel at operational level. Lack of support breeds lack of synergy and hampers working relations. Page 4
4.8 Respect The appalling conditions in healthcare facilities have resulted in lack of respect for healthcare professionals by the communities they serve. The image of healthcare professionals in this regard is tarnished and therefore it is incumbent upon all involved in the healthcare system to address these challenges so as to restore the image of healthcare professionals. 5. Objectives of the campaign The objectives of the campaign are as follows: To raise awareness to all involved in the healthcare system about Positive Practice Environment To facilitate mass mobilization To influence health and safety policies To profile the health profession 6. Scope of the campaign The campaign will be coordinated nationally by the two organizations and it will be officially launched at this level. The activities of the campaign will however be cascaded down to provinces and subsequently to institutions. The campaign will involve the following key stakeholders in the health system: The National Department of Health Department of Public Service and Administration South African Nursing Council and the Health Professions Council of South Africa Department of Labour Members of both DENOSA and SAMA Communities (Hospital Boards, Local radio stations, patients etc) Page 5
7. Lifespan of the campaign The campaign is intended to run over two years. However, the time spent on each of the pillars of the campaign will be dependent upon the effectiveness of each of the activities around these pillars. 8. The approach of the campaign The broad role of stakeholders as identified in the campaign is to ensure that the following aspects as listed below are covered; Adherence and compliance on legislative and other policy decisions, Education through mass mobilisation and awareness, Advocacy and profiling of the health profession. The aforementioned stakeholder will each be expected to play a role in the campaign and the expectant role of each of the stakeholders is hereby outlined. 8.1 Department of Health (DoH) The Department of Health is expected to work jointly with healthcare professionals in seeking solutions to the healthcare challenges in the health system. Greater support for the campaign is also anticipated from the Department of Health. 8.2 Department of Public Service and Administration (DPSA) The DPSA through the Public Health and Social Development Sectoral Bargaining Council (PHSDBC) its wing will assist on bargaining issues. The absence of minimum service agreement for healthcare workers in the country will make it difficult to demonstrate some of the campaign activities such as picketing given that health services are regarded as an essential service and therefore support by the DPSA in this regard is highly anticipated. 8.3 Department of Labour (DoL) The DoL as the custodian of policies and laws governing Health and safety in the workplace will be expected to ensure rigorous compliance by the employer with Health and Safety policies and act on those institutions which are not compliant with these policies. The DoL is also expected to ensure that institutions are inspected to ensure that occupational health and safety mechanisms and measures are adhered to. 8.4 Health Professions Council of South Africa (HPCSA) South African Nursing Council (SANC) Page 6
As the regulatory bodies of healthcare professions SANC and the HPCSA will be expected to play the advocacy role for health and safety of professionals. 8.5 Communities Hospital Boards are the main stakeholder on health matters as far as community interest on health is concerned. The Hospital Boards will act as a link between communities and hospitals in outlining and communicating the challenges within each of the hospitals. Community members including patients themselves will be expected to support this campaign through realizing the ills of the system and work hand-in-hand with health professionals in addressing them. 8.6 Members of DENOSA and SAMA Through their structures at all levels members of the two organizations are expected to actively participate in the campaign activities as ambassadors and foot soldiers to realize its goal and purpose. The vibrancy of the structures at provincial, regional and branch levels will also assist in ensuring the successful implementation of this campaign. 9. Campaign activities The campaign activities will be derived from the 8 main pillars of the campaign. The campaign will take a three-phased approach as follows: Phase One: Safety and Payment Phase Two: Supplies, Resources and Equipment Phase Three: Education, Support and Respect The following specific activities are envisaged namely: Increased awareness through: media clips, videos, newspapers, weekly or bi-weekly internal newsletters Print material: posters, pamphlets, stickers Demonstration through picketing Press conferences Engaging relevant stakeholders through meetings and discussion platforms Use existing calendar events of both partners to drive the campaign Page 7
10. Monitoring and Evaluation The task team shall develop a monitoring and evaluation tool wherein quarterly reviews will be done to assess the developments, successes and the effectiveness of the campaign activities and put remedial measures in place. The tool will contain specific indicators by which the effectiveness of the campaign will be measured. 11. Resources The partners will engage in fund-raising activities to support the campaign. The financial and human resources aspect of the campaign will be equally carried by DENOSA and SAMA. 12. Conclusion The success or failure of this campaign will be highly dependent on the dedication and cooperation of each of the stakeholders involved, working hand-in-hand towards achieving a common goal which is that of ensuring a Positive Practice Environment for health professionals. Furthermore, the support for the campaign from each of the stakeholders will play a pivotal role in ensuring that it becomes a success. The two organizations as the custodians and proponents of this campaign will dedicate necessary resources to facilitate its implementation at all levels. It is therefore incumbent upon all the stakeholders involved to ensure that the campaign succeeds whilst ensuring that a safer and healthier working environment for health professionals is achieved and that patients are safer in hospitals and in healthcare facilities. Page 8